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AAPM 2025 - 67th Annual Meeting & Exhibition of the American Association of Physicists in Medicine

MR Technique Reveals Signs of Rejections in Pediatric Heart Transplant Patients

By MedImaging International staff writers
Posted on 26 Jul 2012

Cardiologists have developed a noninvasive imaging technique that may help establish whether children who have had heart transplants are showing early signs of rejection. The modality could reduce the necessity for these patients to undergo invasive imaging tests every one to two years.

The new method is described online July 2, 2012, in the Journal of Heart and Lung Transplantation. The invasive imaging test, a coronary angiogram, involves inserting a catheter into a blood vessel and injecting a dye to look for hazardous plaque on the walls of arteries feeding blood to the heart. This plaque accumulation indicates coronary artery disease and is an indication that the body may be rejecting the new heart. Because pediatric heart transplant patients are at high risk of developing coronary artery disease, clinicians monitor their arteries on a regular basis. However, recurring angiograms become problematic.

“Many of these children have undergone so many operations, we have lost access to their big blood vessels,” said Charles E. Canter, MD, professor of pediatrics at Washington University School of Medicine in St. Louis (MO, USA). “Sometimes it’s impossible to do catheterization procedures on them.”

Based on experience imaging other sorts of inflammation in arteries, senior author Samuel A. Wickline, MD, a professor of medicine, and his colleagues, including Dr. Canter and medical student Mohammad H. Madani, a Doris Duke Clinical research fellow, examined whether they could assess coronary artery disease in these children using magnetic resonance imaging (MRI). In this case, the MRI was enhanced with a typically used contrast agent called gadolinium that is injected into the arteries. Gadolinium is not radioactive and makes areas of inflamed arteries and heart muscle show up brighter on an MRI. “The brighter it is, the more it is associated with coronary artery disease,” Dr. Canter noted.

The study included 29 heart transplant patients and 8 healthy children who served as controls. The transplant patients underwent standard coronary angiograms as part of their normal care. They also had MRI scans of the coronary arteries to assess whether the noninvasive method correlated with the degree of coronary artery disease discovered in the angiograms. The eight children who served as controls only had MRI scans. The researchers evaluating the MRI results were blinded to the findings of the transplants patients’ angiograms.

Whereas all of the transplant patients’ angiograms showed evidence of plaque build-up, in only six of them was it severe enough for a diagnosis of coronary artery disease. These six patients had the brightest coronary arteries on the MRI scans, compared to both the transplant patients without coronary disease and the healthy control subjects. Still, the 23 transplant patients without diagnosed coronary disease had significantly brighter arteries than the healthy participants. Such evidence demonstrates the need to continue monitoring these patients.

Although the brightness of the arteries on MRI correlated well with a diagnosis of coronary artery disease, gadolinium can be toxic to the kidney, Dr. Canter pointed out. This means the technique cannot be used for patients with poor kidney function. Moreover, sharp images with MRI are difficult in very young children because of their high heart rates. In this study, no participant was younger than age 10. Nevertheless, Dr. Canter envisions a possible future place for this technique in helping to monitor the progress of coronary artery disease in transplant patients.

“The results of this pilot study were very promising,” Dr. Canter said. “But we need to look at more patients. We're in the process of developing a bigger study to confirm and refine the results. I think eventually this could be used as a screening technique, not so much to eliminate, but to reduce the number of angiograms.”

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60 (89.883804321289): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741812 AND published='1' LIMIT 1

61 (!!!!! 1564.0258789062): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

62 (435.82916259766): SELECT fid FROM jos_deeppockets WHERE id=294741812 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294741812 AND published='1' LIMIT 1

63 (44.107437133789): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`

64 (51.975250244141): select jos_twitters.link from jos_twitters where cat=10

65 (30.994415283203): select jos_facebook.link from jos_facebook where cat=10

66 (31.948089599609): select jos_google_plus.link from jos_google_plus where cat=10

67 (29.087066650391): select jos_linkedin.link from jos_linkedin where cat=10

68 (38.14697265625): SELECT fid FROM jos_deeppockets WHERE id=294741812 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294741812 AND published='1' LIMIT 1

69 (32.901763916016): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`

70 (234.84230041504): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294741812 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (215.05355834961): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294741812 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (53.882598876953): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (49.114227294922): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (61.988830566406): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (41.961669921875): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294741812 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (30.040740966797): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294741812 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (34.093856811523): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (48.160552978516): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (62.942504882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741812 AND published='1' LIMIT 1

105 (40.769577026367): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741812 AND published='1' LIMIT 1

106 (48.160552978516): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294741812 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (47.922134399414): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294741812 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (69.856643676758): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741812 AND published='1' LIMIT 1

109 (43.153762817383): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741812 AND published='1' LIMIT 1

110 (48.160552978516): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294741812 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (512.12310791016): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294741812 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (552.89268493652): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (349.04479980469): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (69.856643676758): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741812 AND published='1' LIMIT 1

115 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741812 AND published='1' LIMIT 1

116 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741812 AND published='1' LIMIT 1

117 (36.001205444336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741812 AND published='1' LIMIT 1

118 (48.160552978516): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741812 AND published='1' LIMIT 1

119 (38.14697265625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741812 AND published='1' LIMIT 1

120 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741812 AND published='1' LIMIT 1

121 (36.954879760742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741812 AND published='1' LIMIT 1

122 (275.85029602051): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 33730.030059814): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (457.0484161377): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294741812 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294741812 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 15465.974807739): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (176.19132995605): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (916.0041809082): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (272.03559875488): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (567.19779968262): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (241.04118347168): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (!!!!! 3984.9281311035): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (49.114227294922): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (39.100646972656): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (38.862228393555): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (368.11828613281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741812 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (324.96452331543): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741812 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (43.869018554688): SELECT name FROM jos_deeppockets WHERE id=212

138 (35.04753112793): SELECT name FROM jos_deeppockets WHERE id=212

139 (579.833984375): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (506.87789916992): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (104.90417480469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741812 AND published='1' LIMIT 1

142 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741812 AND published='1' LIMIT 1

143 (!!!!! 7677.0782470703): TRUNCATE TABLE jos_trademed_module

144 (440.12069702148): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294741812 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (396.0132598877): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294741812 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (333.07075500488): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741812 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741812 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (193.11904907227): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741812 AND published='1' LIMIT 1

149 (117.06352233887): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741812 AND published='1' LIMIT 1

150 (!!!!! 1250.9822845459): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (188.11225891113): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741812 AND published='1' LIMIT 1

152 (138.0443572998): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741812 AND published='1' LIMIT 1

153 (!!!!! 5128.1452178955): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294741812 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294741812 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (92.983245849609): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

155 (60.081481933594): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

156 (204.08630371094): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (!!!!! 3821.849822998): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741812 AND published='1' LIMIT 1

158 (152.1110534668): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741812 AND published='1' LIMIT 1

159 (61.03515625): select jos_twitters.link from jos_twitters where cat=10

160 (41.007995605469): select jos_facebook.link from jos_facebook where cat=10

161 (43.153762817383): select jos_google_plus.link from jos_google_plus where cat=10

162 (40.054321289062): select jos_linkedin.link from jos_linkedin where cat=10

163 (344.99168395996): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (!!!!! 4666.805267334): insert into jos_banners_delta values (14615,'2025-06-26 02:42:37','216.73.216.249','view'),(14202,'2025-06-26 02:42:37','216.73.216.249','view'),(14203,'2025-06-26 02:42:37','216.73.216.249','view')

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